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Flashcards in Derm Deck (71):
1

Shave biopsy or full thickness biopsy for melanoma

Full thickness

2

Is shave biopsy okay for BCC

Yes

3

Type of surgery for BCC

MOHs micrographic surgery

4

Recurrence rate of BCC

Less than 5%

5

Describe MOHs microscopic surgery

Removing skin cancer under a dissecting microscope with immediate frozen section; loss of only smallest amount of normal tissue;
No need to remove a wide margin

6

Mohs surgery is best for what location

DELICATE areas--- eyelid or ear

7

2 other places you find kaposis sarcoma

GI
LUNG

8

AIDS from injecting drugs or sexual contact more likely to give kaposis sarcoma

SEXUAL CONTACT

9

Treatment of kaposis sarcoma

HAART (no need to do surgery)
- intra lesions vincristine or IFN
- liposomal doxorubicin= last resort

10

Age of atopic dermatitis

Before 30yo

11

Lichenified

Thickened skin from scratching

12

Scaly rough areas of thickened skin

Eczema

13

What is common with eczema

Secondary infection with S aureus

14

Do food allergies exacerbate atopic dermatitis

NOOOO

15

Tx of eczema skin care

1. Stay moisturized -- lotion and humidifier
2. Avoid bathing, soaps and washcloths
3. Cotton> wool

16

Medical tx eczema

1. Topical steroids
2. Tacrolimus or pimecrolimus-- helps them GET OFF steroids
3. Antihistamines
4. Antibiotics
5. UVB -- severe recalcitrant disease

17

Use of tacrolimus or pimecrolimus in eczema

Helping them GET OFF steroids

18

Severe eczema which anti-histamine

DOXEPINE

19

Mild eczema antihistamines

NON- sedating
Cetirizine, fexofenadine, loratadine

20

Which antibiotics when impetigo in eczema

Cephalexin
Mupirocin
Retapamulin

21

Risk of tacrolimus and pimecrolimus giving lymphoma

LOW RISK

22

Tx of psoriasis local disease

- topical steroids
- vit A and D
- coal tar
- tacrolimus and pimecrolimus

23

Tacrolimus and pimecrolimus use in psoriasis

FACE and PENIS since less potentially deforming

24

How do steroids cause skin atrophy

Inhibit collagen formation and growth
Try and convert all amino acids into glucose for gluconeogenesis

25

Worst prognostic factor skin cancer

Growing lesions

26

Tx of extensive psoriasis

1. UV light
2. Anti-TND
3. MTX

27

Seborrheic dermatitis= dandruff

Hypersensitivity to dermal infection

28

Seborrheic = same as....

benign

29

Dandruff more common in patients with

AIDS
Parkinson's disease

30

What drug associated with pemphigus vulgaris

ACE inhibitors

31

Most accurate diagnosis of pemphigus vulgaris

BIOPSY-- Abs on immunofluorescent

32

No tx of pemphigus vulgaris

DEATH

33

Weaning pemphigus vulgaris patients off steroids with....

Azathioprine or mycophenolate

34

Initial tx of bullous pemphigoid

Prednisone

35

Tx of mild bullous pemphigoid

Erythromycin
DAPSONE
Nicotinamide (not niacin)

36

Porphyria cutanea tarda associated with

HepC
Iron overload
Estrogen use

37

Most accurate diagnostic test in PCT

Increased uroporphyrins in a 24hr urine collection

38

Where does PCT present?

Backs of the hands and face

39

What is Porphyria Cutanea Tarda

Hypersensitivity of skin to abnormal porphyrins when they are exposed to light

40

Number 1 tx of mild impetigo

MUPIROCIN

41

Community acquired MRSA impetigo tx

Doxy
CLINDAMYCIN
TMP-SMX

42

Cause of eryysipelas

Strep> staph

43

Mild skin infections = ORAL

Dicloxacillin, cephalexin, cefadroxyl
Penicillin allergy: erythromycin, clarithromycin
MRSA: doxycycline, clindamycin, TMPSMX

44

Severe skin infections--IV

Oxacillin, nafcillin, cefazolin
Penicillin allergic: clindamycin, vancomycin
MRSA: vancomycin, linezolid, daptomycin, tigecycline, ceftaroline

45

Antistaph penicillins

Ox, clox, diclox, naf

46

Only cephalosporin that covers MRSA

Ceftaroline

47

Penicillin allergy= rash and skin infection use...

Cephalosporins

48

Penicillin allergy= mild anaphylaxis with skin infection use...

Macrolides
Clindamycin
Doxycycline
TMPSMX

49

Penicillin allergy= severe anaphylaxis with skin infection use...

Vancomycin
Linezolid

50

Broad spectrum agents that cover staph but are not specific for skin infections-- NO need to add anything for skin infection if already on them

Second gen cephalosporins
Beta lactam/ beta lactamase combos
Carbapenems

51

Most accurate test for tinea

Fungal culture

52

Best initial tx of tinea

Topical fungal if no hair or nail involvement

53

Best initial tx for hair or nail tinea

TERBINAFINE

54

Best initial test for tinea

KOH

55

Diagnosis of most cases of tinea Cruris

NO specific diagnostic test-- aided by KOH

56

Which specific type of ketoconazole causes Gynaecomastia

ORAL ketoconazole

57

Efficacy of griseofulvin

LESSSSSSSSS than TERBINAFINE or intraconazlle

58

Drugs that causes hypersensitivity reactions are the same that cause hemolysis, interstitial nephritis and often drug induced thrombocytopenia (except heparin)

Penicillins
Sulfa drugs
Allopurinol
Phenytoin
Lamotrigine
NSAIDs

59

Spectrum of skin drug reactions

TEN> SJS> erythema multiforme> morbilliform rash

60

Tx morbilliform rash

No specific tx

61

Tx erythema multiforme

Prednisone

62

Tx of SJS

Steroids are NOT NOT beneficial

Use IV IMMUNOGLOBULINS

63

Do steroids help in TEN

NOOOOOOOO,
Tx= IV IMMUNOGLOBULINS

64

Do antibiotics reverse SSS and TSS

Nooooooo, the just kill the staph producing the toxin

65

Tx mild acne

Benzoyl peroxide

66

Mild acne-- if benzoyl peroxide is ineffective

Clindamycin or erythromycin

67

Tx moderate acne

Topical vit A

68

Topical vitamin A

Tretinoin
Adapalene
Tazarotene

69

Moderate acne-- if the topical vitamin A is ineffective,

Oral antibiotics
- minocycline
- doxycycline

70

Severe acne tx

Oral vitamin A-- isoretinoin

71

Isoretinoin

Teratogenic
Hyperlipidaemia